Department of Endocrinology, Far-Eastern Memorial Hospital, New Taipei City, Taiwan.
Department and Institute of Public Health, College of Medical, National Cheng-Kung University, Tainan, Taiwan.
Gynecol Oncol. 2014 Sep;134(3):576-80. doi: 10.1016/j.ygyno.2014.07.001. Epub 2014 Jul 9.
To investigate whether the risk of developing ovarian cancer is elevated in women with diabetes mellitus.
The study is a population-based cohort study. Women with type 2 diabetes (n=319,310) and age-matched controls (n=319,308) were selected from the ambulatory care claims and beneficiary registry in 2000, respectively. Selected patients were linked to the in-patient claims (2000-2008) to identify admissions due to ovarian (ICD-9-CM: 183.xx) cancer. The person-year approach with Poisson assumption was used to estimate the incidence density rate. The age-specific hazard ratios (HRs) of ovarian cancer in relation to diabetes were calculated using multivariate Cox proportional hazard regression model.
The overall incidence density rate of ovarian cancer was estimated at 1.87 (95% confidence interval (CI) 1.70-2.05) per 10,000 patient-years for patients with diabetes. The corresponding figures for controls were slightly lower at 1.79 per 10,000 patient-years. The incidence density of ovarian cancer was increased with age in diabetes but not in controls. The covariate-adjusted HR for ovarian cancer was statistically compared with null (adjusted HR=1.06, 95% CI=0.92-1.22) in women with diabetes. Moderately elevated HR was noted in women with diabetes aged <50 (adjusted HR=1.17, 95% CI=0.82-1.65) and in women with diabetes aged >65 (adjusted HR=1.10, 95% CI=0.92-1.42). The null association between diabetes and ovarian cancer remains true regardless of the disease duration of diabetes.
This large-scale cohort study provides little support on the putative association between type 2 diabetes and the risk of ovarian cancer.
探讨糖尿病女性患卵巢癌的风险是否增加。
本研究为基于人群的队列研究。分别于 2000 年从门诊护理索赔和受益登记处选取 319310 例 2 型糖尿病（T2DM）女性患者和年龄匹配的对照者（n=319308）。选择的患者与住院患者索赔（2000-2008 年）相关联，以确定因卵巢（ICD-9-CM：183.xx）癌入院的人数。采用泊松假设的人年法估计发病率密度率。使用多变量 Cox 比例风险回归模型计算与糖尿病相关的卵巢癌的年龄特异性风险比（HR）。
糖尿病患者的总体卵巢癌发病率密度率估计为 1.87（95%置信区间（CI）为 1.70-2.05）/10000 患者年。对照组的相应数字略低，为 1.79/10000 患者年。卵巢癌的发病率密度随年龄在糖尿病患者中增加，但在对照组中没有增加。与糖尿病患者相比，卵巢癌的协变量调整 HR 统计学上与零（调整 HR=1.06，95%CI=0.92-1.22）进行了比较。在年龄<50 岁的糖尿病女性（调整 HR=1.17，95%CI=0.82-1.65）和年龄>65 岁的糖尿病女性（调整 HR=1.10，95%CI=0.92-1.42）中，HR 略高。无论糖尿病的疾病持续时间如何，糖尿病与卵巢癌之间的这种零关联仍然成立。
这项大规模的队列研究几乎没有支持 2 型糖尿病与卵巢癌风险之间的假定关联。
